Provider Demographics
NPI:1265063176
Name:MERIDA, MARIA ARYZA BELTRAN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARIA ARYZA
Middle Name:BELTRAN
Last Name:MERIDA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:MARIA ARYZA
Other - Middle Name:BELTRAN
Other - Last Name:MERIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:8270 WILLOW OAKS CORPORATE DR STE 2127
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4511
Mailing Address - Country:US
Mailing Address - Phone:571-423-4171
Mailing Address - Fax:
Practice Address - Street 1:8270 WILLOW OAKS CORPORATE DR STE 2127
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4511
Practice Address - Country:US
Practice Address - Phone:571-423-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202009386235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist